It has generally been appreciated in the art that lowering the temperature of body tissues can limit trauma due to surgery. The present inventors have been involved in using cooling to prevent collateral damage during prostate surgery through the use of an endorectal cooling system (ECB). Their original system included intracorporeal cooling irrigation as an adjunct to endorectal cooling, to induce local hypothermia of the pelvis during radical prostatectomy (and other laparoscopic/robotic procedures) to reduce inflammation and neuromuscular injury and thereby to promote functional recovery outcomes (urinary and sexual function after radical prostatectomy). The cold irrigation creates an additive effect to the endorectal cooling to enhance cooling, clears the operative field of blood to improve visualization, and reduces thermal spread and minimizes collateral injury when using thermal electrocautery for hemostasis; this is particularly important when performing the nerve sparing part of the operation where one tries to minimize damage to the delicate neurovascular bundles. We demonstrated a statistically significant faster rate of continence recovery with hypothermia. This work represented the first ever application of hypothermia to radical prostatectomy. The research manuscript which has now been published in Urology, 2009 Feb. 26, notes, “Adjunctive.”
The present invention concerns cooling of surrounding tissues prior to surgery. A modified Foley catheter is described for providing urethral cooling during and after prostate or other surgery of the urogenital system. Cooling of the urethra is achieved by circulating chilled fluid through a coiled capillary tube that is in contact with the catheter's wall. This cools the urethra as well as urethral sphincter. Additional cooling can be provided by circulating the chilled fluid within the bladder. An improved cautery instrument is also disclosed. This system is a normal cautery instrument equipped with cryogenic emitters disposed about the tips. A blast of cryogenic fluid is emitted just prior to energizing the cauterizing tip to lower the temperature of the tissue to be cauterized.